Adaptive reuse of buildings in the healthcare industry

James K. Elrod and John L. Fortenberry Jr. discuss their new article on the practice of adaptive reuse and its application in the healthcare industry. This article is featured as part of a special supplement in BMC Health Services Research. Additional articles presented in the supplement focus on centers of excellence, the hub-and-spoke organization design, and innovation in healthcare institutions.

Abandoned buildings are a common and unfortunate sight in communities, emerging for myriad reasons ranging from progress, which compels establishments to relocate to better serve clients, to misfortune, which prompts businesses to cease operations at particular locations.

While many overlook dilapidated buildings altogether . . . others see opportunities for, of all things, enhancing the depth and breadth of healthcare services in communities.

In their idled states, these buildings often fall into disrepair, diminishing scenic beauty and even posing threats to health and safety as abandoned structures are vulnerable to criminal and environmental elements. While many overlook dilapidated buildings altogether, considering them to be well suited only for the wrecking ball, others see opportunities for, of all things, enhancing the depth and breadth of healthcare services in communities.

Willis-Knighton Health System and adaptive reuse

Shreveport, Louisiana-based Willis-Knighton Health System has extensive adaptive reuse experience and credits the practice with facilitating expansion initiatives which have improved access to care in the community. The system decided to tap into the unrealized potential of abandoned buildings beginning in the 1970s as a means of acquiring space economically as it expanded its presence in the market. Its initial repurposing endeavors proved economical and effective, compelling subsequent pursuits.

To date, Willis-Knighton Health System has successfully accomplished over 20 adaptive reuse projects. Its most recently completed initiative involved repurposing the former Doctors’ Hospital of Shreveport, a 150,000 square foot building that ceased operations in 2010 and quickly became a prominent blight overlooking the heart of downtown Shreveport.

The building, reintroduced in 2017 as the WK Rehabilitation Institute, is virtually indistinguishable from brand new construction and features an entirely revised facade, all-new interior elements, and an enhanced layout which facilitates access. The building cost $26 million (acquisition plus renovations), a bargain price, especially when considering that equivalent new construction would total $44.5 million.

Opportunities associated with adaptive reuse

The potential possessed by adaptive reuse to deliver significant financial savings unavailable through equivalent new construction projects is perhaps its most notable benefit. In fact, this attribute is cited as the primary motivation for its pursuit, and in each of Willis-Knighton Health System’s experiences, cost advantages over equivalent new construction scenarios were observed. This point certainly shouldn’t be lost on those serving in the healthcare industry.

The physical space required by physicians, nurses, administrators, and others to carry out their many duties often represents a significant expenditure, consuming financial resources which otherwise could be directed toward patient care. Economies achieved on this front permit more resources to be directed toward mission fulfillment activities and adaptive reuse offers a prudent method for realizing such.

Beyond financial advantages, adaptive reuse offers opportunities for healthcare entities to bolster community renewal initiatives by returning to service formerly inactive properties. Further, the practice is environmentally friendly, as repurposing abandoned buildings conserves resources and averts demolition, reducing the burden on landfills which otherwise would have to accommodate the waste. Adaptive reuse also has the potential to bring highly-prized locations in communities back into consideration in circumstances where relocations or closures present optimally situated availabilities.

All in all, adaptive reuse offers a unique and mutually beneficial method for addressing the spatial expansion needs of healthcare institutions, providing those serving in hospitals, medical clinics, and other care providing facilities with an option to consider beyond traditional renovation and new construction pathways. The practice by its very nature coincides nicely with the community-minded, altruistic missions typically espoused by healthcare establishments, affording an exceptional strategic fit when proper circumstances present themselves.

For additional insights on the practice of adaptive reuse, including descriptions of opportunities and obstacles, case presentations profiling several of Willis-Knighton Health System’s repurposing initiatives, and a detailed operational framework, consult the associated article featured in BMC Health Services Research.

James K. Elrod is President and Chief Executive Officer of Shreveport, Louisiana-based Willis-Knighton Health System and is America’s longest-tenured hospital administrator. He is also the author of Breadcrumbs to Cheesecake, a book which chronicles the history of Willis-Knighton Health System.

John L. Fortenberry Jr. is Chair of the James K. Elrod Department of Health Administration, James K. Elrod Professor of Health Administration, and Professor of Marketing in the School of Business at LSU Shreveport. He is the author of six books, including Health Care Marketing: Tools and Techniques, 3rd Edition. Dr. Fortenberry also serves as Senior Advisor for Marketing and Strategy at Willis-Knighton Health System.